EMS units at heart of council discussion
Councilman says present system is costing Howell a significant amount
BY TOYNETT HALL Staff Writer
Acall goes out for one of Howell's emergency medical services (EMS) units to respond to an incident. The first responders on the scene happen to be a volunteer first aid squad. These volunteers administer first aid care before handing off the patient to a paid EMS squad for transport to a hospital.

This scenario could become reality in Howell after data compiled by Deputy Mayor Mike Howell revealed that income generated by the EMS units is considerably below the cost of operation.

The issue of emergency medical services was discussed during the May 6 meeting of the Howell Township Council.

As officials were considering what direction they may want to take, Mayor Joseph DiBella sounded a note of caution that evening.

"Everybody wants to find the right solution. We need to understand all of the facts. We need to be conscious of all the implications of what this may or may not do to the volunteer services we built up in the community," DiBella said.

"There are a few things we have to get right … police, fire, EMS. If this gets screwed up, somebody's going to die, and we don't want to be in a situation where we didn't go about this very carefully and very methodically," the mayor added.

One officer from a volunteer first aid squad urged officials to proceed with caution before making changes in the way calls have been handled for years.

Emergency medical services in Howell are provided by three volunteer first aid squads - the Howell, Farmingdale-Howell and Ramtown first aid squads - and by the Howell Police Department's professional Emergency Medical Service Unit which is staffed by one crew from 5 a.m. to 2:30 p.m., and a second crew from 11 a.m. to 9 p.m.

It was noted that once a volunteer first aid squad responds to an emergency call and transports the patient to a hospital, the township cannot bill the patient's insurance provider for reimbursement.

A study conducted from May 2007 to January 2008 revealed that these practices have led the township to incur a loss of $243,000. The township provides each volunteer first aid squad with a $70,000 annual appropriation.

Howell suggested that "all calls generated while the paid EMS crews are on duty be handled by the paid EMS, allowing the township to bill for the services. We sat up here during these budget hearings saying that we have to find ways to generate revenue. Here's a way that we already have in place to generate revenue. To have this (police EMS) unit pay its own bills and to put more money into the township's funds that we could use to provide additional services.

"I don't think anybody here wants to slight what the volunteers do, but we need to have them work with us and allow us to continue to provide for residents a paid EMS, during the hours the folks are on," Howell said. "I'm not trying to take away anything from the volunteers. Go to the scene, provide the first aid that the patient needs if it's a life or death situation. We're not telling you (the volunteers) to sit there while somebody stops breathing, or somebody's having a heart attack."

Howell First Aid and Rescue Squad No. 1 Capt. Jeff DeMatteo disagreed with Howell's proposal.

"The amount of money that you are going to make for anything does not make up for somebody's life.Alot of times we respond before the paid crew does," DeMatteo said. "Who is going to decide if it's a real emergency or it's not? If you call 911 you are calling because you have an emergency.

"We have 67 members and we answer 2,200 calls a year.We're getting penalized because we are answering too many calls. We're getting there too quick and we're transporting too many patients, and not allowing the paid crew to do it," he said.

DeMatteo said it would be a poor decision not to allow the volunteers to follow through once they have responded to an emergency situation.

"Our people are volunteers. They like working with the community. They like taking the patient to the hospital and following it all the way through. It keeps their skills up and they're helping the patient," the first aid squad captain said.

DiBella said, "Anumber of the first aid squad members had relayed to me that in the middle of treating a patient, it's kind of difficult to do a hand-off and put them in another ambulance. That might not be in the best interest of the patient."

He also reminded the council that the township is obligated to protect the status of their volunteers.

"The moment a volunteer charges, they are no longer a volunteer and therefore they are subject to all types of problems. In spite of the fact that they could be saving someone's life, they are now open to very significant litigation situations," he said.

DiBella suggested that the township implement a blanket fee.

"They are using vehicles purchased by the township, fueled by the township, maintained and repaired by the township … why could we not just add on and bill the (patients') insurance companies a flat per trip fee that goes back to the township to account for vehicle expenses, fuel and maintenance?"

DiBella asked councilwomen Angela Dalton and Cynthia Schomaker to contact all three volunteer squads for input on this situation. The mayor directed TownshipManager Helene Schlegel to schedule a meeting with representatives of the first aid squads and to present a report to the council in the next few weeks.